31 years old, POP w/ 1st child - 9 1/2 wks pp

Disclaimer: This is a long post:
I am 31 years old and had my 1st baby 9 1/2 weeks ago. I had a difficult delivery, and I have had a difficult postpartum period. My daughter was 8 lbs 2 oz at birth. She was occiput posterior. My OB attempted to rotate her during the pushing phase, but she did not fully turn. I pushed for a little over 2 hours. At that time, we were given the option of using forceps/vacuum with risk of severe laceration or C-section. I went into the labor/delivery process wanting to avoid both of these issues, but you just never know how things will work out. At the time, I was in no shape to really make that decision. My daughter was already engaged in my pelvis at the time, and frankly, either option would have been difficult. So, my OB attempted forceps but they did not work. He used the vacuum. She was delivered sideways. I had an episiotomy with 3rd degree extension. She was born happy and healthy. My initial physical recovery was fine. I do not know if I was running on adrenaline or what, but I remember thinking "wow, I feel great quickly." Mentally, I struggled with the baby blues. I had numerous breastfeeding challenges that ended with mastitis, but we are now breastfeeding successfully. Right before my 6 week postpartum visit, I noticed that "things did not feel right down there." I asked my OB about it like this "are things in the right place?" He said yes and that maybe I had experienced some swelling. Two weeks later I developed an issue with the episiotomy repair, so I returned to him. 1) Part of the episiotomy is not healing completely. 2) I asked AGAIN about the "bulge." He finally got a mirror and showed me that my bladder was indeed prolapsed. Long and short of our conversation was that he sees much worse than mine all day. What? I made an appointment with a urogyn on my own. He assessed the episiotomy issue and put me on antibiotics and diagnosed me with grade 2 anterior (bladder), grade 1 apical (uterus) and grade 1 posterior (rectum) prolapses. I am devastated by this. Most days, I feel the bulge of my bladder with all activity, including walking, sitting, etc. At times, I feel like I cannot fully empty my bladder. The urogyn said no surgery until we decide we are done with having children. He set me up to do pelvic floor therapy with his NP and told me to do Kegels on my own. He said that a pessary may help if the therapy does not. I am so depressed now. I feel like I will never be normal again - never be able to enjoy physical activity, never be able to run/play/jump/lift my baby, never be able to have sex again, etc. all without discomfort or fear of making things worse. I am also so sad that I feel traumatized and scared to ever have any more children. We had planned on at least 2. I am so desperate for help. So, my questions are these:
1) Anyone out there my age or know anyone my age who is dealing with this and what is/was the outcome? Any others who are NOT my age, please feel free to answer as well!
2) Any idea if things get better on their own, given that I am 9 1/2 weeks postpartum? Does breastfeeding make it worse?
3) Any success with pelvic floor therapy?
4) Any success with a pessary and how long can you use them (i.e., years)?
5) How do you cope emotionally? I am a wreck...
6) Any other information, advice, suggestions, etc.?

Hi, glad you came to this forum. I understand your anxiety as I had prolapse and had surgery this past September. I will try to help you by answering your questions
1. I am not your age (50's) but have heard from post partum women who developed prolapse through childbirth. You are not alone!
2. Yes,things can get better and yes, breastfeeding can affect prolapse.
3. Pelvic floor therapy can help as long as you go to a pt who specializes in the pelvic floor. Ask for recommendations from on-gyn or urogynecologist. They can be far and few especially in more rural areas.
4. Pessary can be a wonderful relief of pressure and heaviness. Again it is important to have an experienced healthcare professional fit you with one the right size and type. Make sure before you leave the offiice that you are in control of using the pessary, taking out, putting in etc. I made the mistake of going home with the pessary not knowing what to do with and feeling scared and worried about what I could do with it.
5. This was the worst part for me because I also had pain with my prolapse. I ended up going to a mental health counselor because I knew it was taking over my life and I needed help. My best emotional support came from other women who also experienced prolapse. There is a pelvic organ prolapse Facebook group that I recommend you to join. Not sure I can tell you the name here but try and google it.
6. We are all different with our symtoms (symptoms) even though we share the same condition. Prolapse is never life threatening but can be life altering. Your age can be a positive plus in overcoming your prolapse without surgery. There are strengthening exercises including the more known kegals that when done correctly with guidance from a pt can actually help reverse your prolapse. Your body has been through a very traumatic experience along with your hormones and time in this case is on your side. There is help out there for you. You have already taken an important step in helping yourself by posting your concerns here. There is a website dedicated to prolapse called APOP, check it out. If we can guide you any further just let us know. Positive thoughts are sent your way!

Hi The advice above seems to cover most of the possible issues very comprehensively, but just to add I WAS YOU, exactly the same situation with my first boy ( i'm now 44), Gyn said to wait until family was complete...I had 4!! everything improved during the pregnancies ( I felt like a new woman). I'm sure that breastfeeding was an advantage ( I did for a year each.....not showing off, self employed, i could).
Had hysterectomy at 39, but wished i had gone to urogyn, as i just had a laproscopic sacrocopoplexy ( and from this site it seems all could have been done together). I'm not in any place to say I did things the right way,and as a bit of a running fiend (but no core strength) i did much unnecessary damage, and i have suffered severe constipation since childhood so diet has to be extra careful)
If you are strict about the kegels you will probably save yourself much damage, stick to cycling for exercise? you are still early days following a difficult labour but have every chance of fully recovering and choosing how many children you want. I'm not a medic.Enjoy your baby sounds like you are gutsy!

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